Surgery is an option for people with severe, difficult-to-control GERD symptoms or people who have complications such as asthma or pneumonia, or strictures (blockages) of the esophagus from scar tissue. Some people who do not want to take medications for a long time may choose surgery.
Surgery for GERD can be done using camera-guided instruments, a technique called laparoscopic surgery. Laparoscopic surgery requires smaller incisions than conventional surgery. In a procedure called Nissen fundoplication, excess stomach tissue is folded around the esophagus and sewn in place, to hold extra pressure around the weakened esophageal sphincter. This operation appears to relieve symptoms about as much as prescription acid-blocking medicines. The success rates of surgery might be lower for people whose symptoms are not relieved by anti-acid medicines. Following surgery, about one out of five people will have a lasting bothersome side effect, but most people who undergo surgery are very satisfied with the results. Potential side effects include swallowing difficulty, diarrhea and the inability to belch or vomit to relieve bloating or nausea.
Endoscopy treatments Three new treatments have been developed to tighten the lower esophageal sphincter using an endoscope. An endoscope is a flexible tube that can be passed through the mouth and throat to examine the interior of the esophagus. The three treatments are stitching ("plication"), heating (the "Stretta" procedure), and injection of the sphincter with a bulking material (the "Enteryx" procedure). All three endoscopic treatments were developed recently, so their long-term success rates are unknown and little is known about their potential complications. They are not yet widely available, but they are being offered at an increasing number of medical centers.
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